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Qualifying for Benefits Under a Psychological Disability

Qualifying for Benefits Under a Psychological Disability

Of the nation’s 8 million disability benefit recipients through Social Security—either through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)—a quarter of them are receiving benefits with a mental impairment as their primary qualification or diagnosis. Additionally, many psychological disabilities are comorbid, which means they occur in conjunction with another disorder.

To qualify for disability benefits under a mental impairment, your condition must have been diagnosed by a doctor, and your condition must: 1) prevent you from doing any work that you have done up until the time you became disabled; 2) render you unable to reasonably be trained for other work that is available at the time you became disabled; and 3) be long-term or be expected to last at least one year. You must also show that you are receiving and complying with treatment.

In addition to the above, an applicant for disability benefits due specifically to depression will also need to show extreme inability or difficulty performing in any area of mental functioning or a marked difficulty with any two of the following areas: 1) interacting with others; 2) concentrating or completing tasks; 3) understanding, remembering, and applying learned information; or 4) adapting oneself to situations.

Social Security’s Blue Book divides mental disorders that can qualify you for disability benefits into nine categories, each with their own set of criteria that must be met: 1) affective disorders; 2) anxiety disorders; 3) autism and related disorders; 4) mental retardation; 5) organic mental disorders; 6) personality disorders; 7) schizophrenia, paranoia, and psychotic disorders; 8) somatoform disorders; and 9) substance addiction.

As part of the process, the Social Security Administration (SSA) completes a form called the Psychiatric Review Technique Form (PRTF) to help it make a determination on whether you qualify for benefits based on your mental condition. The PRTF is divided into four sections: 1) medical summary; 2) documentation of factors that evidence the disorder; 3) rating of functional limitations; and 4) consultant notes. Your doctor will complete the residual functional capacity (RFC) form to see if you can perform simple, unskilled work.

Despite the prevalence of mental impairments as disability qualifiers, it can be more difficult to get approved for benefits than it is to qualify under a physical disability. Unfortunately, symptoms of mental illness cannot be evaluated easily, and the severity of the symptoms are difficult to measure objectively. Furthermore, the disability examiners who review cases initially are not licensed psychiatrists; they often lack the sophistication to understand how limiting mental conditions can be on a person’s ability to work. Some may even think that people who apply for benefits on the basis of a mental impairment are just lazy or faking symptoms to get benefits.

However, the potentially uphill battle should not deter you from trying to get disability benefits. The list of medical disorders that SSA evaluates is not complete, so even if you do not meet a Blue Book listing, you may still qualify. Consider hiring an experienced disability attorney to represent you. And definitely keep a running journal of how your mental disability affects your life on a daily basis—SSA will take your daily activities into account when deciding whether to approve you for benefits.